In periodontally compromised teeth, problems such as migration, black triangles, gingival asymmetry, and increased clinical crown length do not disappear—even after successful periodontal therapy. Therefore, if the patient’s primary complaint is esthetics, periodontal treatment alone does not resolve the fundamental issue.
Conversely, when the tooth itself requires veneers or laminates due to shape or contour deficiencies, an additional layer of risk is introduced into an already vulnerable system:
🔵 Key Insight
Much of the long-term prognostic data in periodontal literature is valid only under a crucial assumption:
the patient maintains excellent plaque control and adheres consistently to supportive periodontal therapy (SPT).
However, once an esthetic layer is placed on the tooth, this essential prerequisite—optimal plaque control—may be compromised. Consequently, real-world outcomes may no longer align with the prognoses reported in the literature.
Therefore:
Relying on periodontal prognostic data when planning esthetic intervention on a compromised tooth is biologically questionable.
After the addition of an esthetic layer, the tooth no longer behaves under the same biological conditions upon which those studies were based.